HOUSE APPROVES BUDGET CUTBACKS OF $39.5 BILLION

By SHERYL GAY STOLBERG

Published: February 2, 2006

House Republicans eked out a victory on a $39.5 billion budget-cutting package on Wednesday, with a handful of skittish Republicans switching their votes at the last minute in opposition to reductions in spending on health and education programs.

The vote helped President Bush deliver on his promise to rein in federal spending while underscoring deep anxiety within his party over cutting social welfare programs in an election year.

The measure represents the first major effort by lawmakers since 1997 to cut the growth of so-called entitlement programs, including student loans, crop subsidies and Medicaid, in which spending is determined by eligibility criteria.

It passed 216 to 214, with 13 Republicans voting against. The Senate, with Vice President Dick Cheney casting the decisive vote, approved the spending cuts in December. The bill now goes to the White House for Mr. Bush's signature.

Coming on the heels of the State of the Union address, the vote was a critical test of Mr. Bush's ability to hold his fractured party together.

The House also voted Wednesday to extend the broad antiterrorism bill known as the USA Patriot Act until March 10, giving House and Senate negotiators time to settle differences on another of Mr. Bush's priorities, a measure to revamp the act and make it permanent.

The spending bill, which covers a five-year period ending in 2010, will achieve savings of $6.4 billion in Medicare, the health care program for the elderly, through a variety of changes that include higher premiums for all beneficiaries, with steeper increases for the more affluent and a freeze in payments to home health care providers.

In the Medicaid health care program for the poor and disabled, $4.8 billion will be saved in part by increasing co-payments and reducing payments for prescription drugs.

Mr. Bush said that he looked forward to signing the legislation and that the budget proposal he would send to Congress on Monday ''will continue to build on the spending restraint we have achieved.''

After years of cutting into social programs, the budget vote spotlighted how difficult it will be for Mr. Bush to press ahead with even deeper cuts this year. While the bill has strong appeal to fiscal conservatives who are Mr. Bush's Republican base, it makes party moderates nervous -- so much so that four switched their votes to oppose the bill after intensive lobbying from advocacy groups over the holiday break.

Determined to see the measure pass even as they knew it would make life tough for party members, Republican leaders waged their own intense lobbying campaign. Representative Roy Blunt of Missouri, the Republican whip and acting majority leader, could be seen on the House floor deep in conversation with his colleagues as the roll was being called, apparently counting votes until the last minute so he could determine which moderates could be released to vote no.

With House leadership elections set for Thursday, Mr. Blunt, the front-runner for majority leader, had a personal stake in the outcome.

''Clearly, if we hadn't won it would be a huge thing,'' Mr. Blunt said after the vote. ''But it's really not about me. It's about the members coming back and taking a very tough vote.''

So tough that some moderates who voted in favor of the measure later felt compelled to defend themselves. Among them was Representative Sherwood Boehlert, Republican of New York, who called it ''a very agonizing'' decision. But Mr. Boehlert, one of three Republicans to vote against a recent tax-cutting bill, said he had become convinced that entitlement programs must be revamped before they gobbled up the entire federal budget.

''The present course is unsustainable,'' he said. ''We can't keep cutting taxes and cutting revenues, while cutting programs to protect the most vulnerable in society.''

But conservatives, who pushed hard within their caucus for the cuts, were delighted. Representative Mike Pence, Republican of Indiana, a leader of a group of House conservatives, called the vote ''a step toward restoring public confidence in the fiscal integrity of our national legislature.''

With the Senate taking up a tax-cutting measure at the same time, Democrats used debate on the measure to sound what will be a major election-year theme: that Republicans are cutting taxes for the rich at the expense of services for the poor.

''A vote for this bill is a vote, literally, to take away from health care from our children so we can give more money to the super-rich,'' Representative Louise M. Slaughter, Democrat of New York, said.

At a time Congress is consumed by a lobbying scandal, Democrats complained bitterly that the measure had been written without them, with the help of paid representatives from the drug and insurance industries, and then presented for a vote before they had a chance to review it.

''This is a product of special interest lobbying,'' said Representative John D. Dingell, Democrat of Michigan, ''and the stench of special interests hangs over the chamber as we consider it today.''

The budget-cutting bill is actually a holdover from last year. It first passed the House just before Christmas in an all-night marathon session. The vote was 212 to 206, with nine Republicans joining 196 Democrats and one independent in opposition. The bill then went to the Senate, which made a few minor changes, forcing the House to reconsider it on returning this week.

Those tweaks, and the resulting delay, gave groups like AARP, which represents retirees, and Americans United, a progressive advocacy group that fought Mr. Bush's plan to revamp Social Security, time to mount an aggressive campaign against the cuts, and they did.

Brad Woodhouse of Americans United, said his group ran more than 300 events nationwide during the Congressional winter recess ''to create the type of wave we created against the privatization plan.'' John Rother, AARP's policy director, said his group had run print advertisements and focused on Congress members in swing districts.

Mr. Rother said AARP objected in particular to a provision in the bill that would temporarily strip Medicaid coverage from elderly nursing home residents if they had given away money in the previous five years. The provision would cover money given to charity, he said, or to a grandchild for tuition; recipients would lose coverage in an amount equal to what they had given, he said, adding that lawmakers were often surprised to learn of the language.

''It's really punitive -- inhumane is the other word I would use,'' he said. ''I think a lot of these guys had no idea that was in there when they voted on this.'' Still, he said it had been difficult to persuade lawmakers to switch their votes. ''It's tough for these people to say openly, 'I made a mistake; I didn't know what I was voting on.' ''

The four who did were Representatives Rob Simmons of Connecticut, who announced his decision last week, Jim Gerlach of Pennsylvania, John E. Sweeney of New York and Jim Ramstad of Minnesota.

In a statement after the vote, Mr. Gerlach said he was ''very concerned about how the legislation reduces funding for mental health and education as well as important health care areas that will ultimately target our nation's most needy citizens.''